Phlebotomy: Hitting the Vein in a Venipuncture

[AziaCole]

Hello.

 

I am a third year Medical Technology student. In our country, Phlebotomy is almost always done by the MedTechs. You can say that it is a very, very vital skill for me to learn. However, no matter how many times I've done it, I can't seem to get it right.

 

Our class is using vacutainers and is currently working on the median cubital vein. While I have no problem locating the vein with my fingers, everytime I slide the needle in, no blood comes out when I finally insert the vacutainer tube. I always, always seem to be missing the vein. Is there any tips or tricksin hitting the veins? How would you know if you've already hit one? My uncle, an old student of Physical Therapist, said that muscles feels smooth, veins are hard. Is this true?

 

I really need to get this right to pass my course. I already pity my siter who has been acting as my own personal guinea pig and I've wasted to much multi-sample needles and vacutainer tubes. Any help? I am about to cry from frustration.

[Phi for All]

There are some YouTube videos if you search for "drawing blood with vacutainer". I haven't seem them, but I've found lots of other expertise being flaunted on YouTube. Some people like to share how they make things look so easy.

[AziaCole]

I have watched quite a bit of videos from youtube. Most of them are pretty much the same thing as what our teacher have taught us. I haven't however, found one that deals with hitting the veins. Though, if anybody had, please, please send me a link.

 

Thanks.

[imatfaal]

Unfo it is very much a aptitude that you can learn rather than a technique that can be broken down into manageable steps. When I was at medical school the major reason for failure was lack of confidence - the vein does feel different to muscle and very very different to the tissue surrounding the medial cubital; the easy route which requires no force is to slide past the vessel, to enter the vessel does require a tiny bit more force. This extra push can often cause those lacking confidence to miss as they are uncertain of the force required. Its a practice and feel thing.

 

There are things that you can check you are doing in the same manner as your instructors; angle of the arm, angle the lower arm is making with the arm, the "attack" of the hypodermic needle, tightness of any tourniquet - but it is all really practice.

 

A few other things - most of our lab learned to take blood on my poor lab partner who was a rugby player of national standard; his median cubital was like a rope. My median cubital is however almost non-existent - and even the head of cardiothoracic surgery couldn't find it with a needle (and lost a bet with one of his team who was my tutor). The point of this story is to make sure you find a willing test subject who has a good vein that most people could find.

 

And finally - talk to your instructors; they will almost certainly understand and be able to help. If you don't talk to them now and this becomes a problem then they will have every right to say "If you had told us earlier we could have done something" - but if you leave talking to them till you have failed something then it is already too late

[physica]

A tactic I use is to find where the vein splits in two and aim in the middle of that V. This is useful in elderly patients as their veins move and this prevents the needle from sliding alongside the vein.